• From 1975 to 1980, 106 infants in the first year of life with complex cardiac anomalies underwent isolated intra-atrial repair; 70 were in the first 3 months of life. Of these 70, 39 were 1 to 3 months old, 15 were 1 week to 1 month old, and 16 were less than 1 week old. The median age was 70 days, the range, 1 to 360 days. These infants included 74 with transposition of the great arteries, 28 with total anomalous pulmonary venous connection, and four with complex lesions (cor triatriatum and combined total anomalous pulmonary venous connection and anomalous systemic connection). Overall survival was 95%; for those in the first 3 months of life, 96%; for those in the first month, 94%; and for those in the first week, 100%. Age was not a determinant of survival. Attempts to delay surgical intervention once symptoms appear only results in clinical deterioration and interim mortality.